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Accessory Vein Obliteration and Balloon-Assisted Maturation for Immature Arteriovenous Fistulas for Haemodialysis: A Systematic Review and Meta-Analysis

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  • Venous Interventions
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Abstract

Purpose

This study aims to examine outcomes of immature arteriovenous fistula salvage using balloon angioplasty (PTA) without and with accessory vein obliteration (PTA + VO).

Materials and Methods

PubMed and Embase were accessed on 21 September 2020 to retrieve cohort studies on adult patients with end-stage renal failure (ESRF) requiring dialysis. Risk of bias was assessed using Newcastle–Ottawa Scale. Studies were pooled into PTA or PTA + VO arms, with outcomes (technical/clinical success, primary/secondary post-intervention patency until 12 months) reported as event rates with 95% confidence intervals. Random-effects model and maximum likelihood meta-regression were used for meta-analysis.

Results

Fourteen studies (1030 participants) were included. The between-subgroup difference in outcomes was largely non-significant (p > 0.050).

Conclusion

The evidence does not support balloon angioplasty with concomitant accessory vein obliteration for immature fistula salvage.

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Acknowledgements

The authors would like to thank Ms Annelissa Chin from Medical Library (National University of Singapore) as well as Dr Chan Sze Ling (Health Services Research Centre, SingHealth) for offering technical expertise during the project conception phase.

Funding

This study was not supported by any funding.

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Authors and Affiliations

  1. Duke-NUS Medical School, Singapore, 169857, Singapore

    G. Y. Purwono, R. Sultana & T. Y. Tang

  2. Yong Loo Lin School of Medicine, Singapore, 117597, Singapore

    R. E. Lee

  3. Department of Vascular Surgery, Singapore General Hospital, Singapore, 169856, Singapore

    C. J. Q. Yap, S. X. Y. Soon, T. T. Chong & T. Y. Tang

  4. Department of Renal Medicine, Singapore General Hospital, Singapore, 169856, Singapore

    R. Y. Tan & C. S. Tan

Authors
  1. G. Y. Purwono
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  2. R. Sultana
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  4. C. J. Q. Yap
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  5. S. X. Y. Soon
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  6. R. Y. Tan
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  7. C. S. Tan
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Correspondence to T. Y. Tang.

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Purwono, G.Y., Sultana, R., Lee, R.E. et al. Accessory Vein Obliteration and Balloon-Assisted Maturation for Immature Arteriovenous Fistulas for Haemodialysis: A Systematic Review and Meta-Analysis. Cardiovasc Intervent Radiol 45, 1415–1427 (2022). https://doi.org/10.1007/s00270-022-03212-0

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  • DOI: https://doi.org/10.1007/s00270-022-03212-0

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